JMIR Publications

ABSTRACT

Background:

Contemporary management approaches for gestational diabetes mellitus (GDM) exhibit insufficient implementation, resulting in suboptimal glycemic control and preventable perinatal complications.

Objective:

We aim to evaluate the impact of a telemedicine-enhanced integrated management system on pregnancy outcomes and glycemic control in women with GDM.

Methods:

In this real-world, prospective cohort study, women with GDM were categorized into standard care (standard care group) and TangMama smartphone app plus standard care (telemedicine-enhanced group). We compared pregnancy outcomes and glycemic parameters between these two groups in an inverse probability of treatment weighting (IPTW) population based on propensity scores.

Results:

A total of 4621 women with GDM were included, with 1711 in the telemedicine-enhanced group and 2910 in the standard care group. Upon IPTW analysis, the telemedicine-enhanced group was associated with significantly reduced risk of cesarean section (aOR 0.80 [95%CI 0.71 to 0.91]), lower gestational weight gain (adjusted mean difference -1.49 kg [-1.81 to -1.17]), and improved glycemic control in the third trimester after adjusting for potential confounders. For neonatal outcomes, the telemedicine-enhanced intervention was associated with lower rates of preterm birth (aOR 0.47 [0.38 to 0.59]), large-for-gestational-age (aOR 0.81 [0.69 to 0.96]), low birth weight (aOR 0.39 [0.29 to 0.52]), neonatal hypoglycemia (aOR 0.64 [0.45 to 0.93]), and neonatal hyperbilirubinemia (aOR 0.69 [0.58 to 0.82]).

Conclusions:

Telemedicine-enhanced integrated management is associated with better maternal glycemic control and reductions in adverse pregnancy outcomes among women with GDM. This approach can optimize prenatal care and offer important implications for enhancing the implementation of evidence-based GDM care.